| NPI | 1811161763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS 810147) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 5602) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2021-06-10 |